Just more than three years ago, a program quietly came to Valencia County that has resulted in greater public health.

On Dec. 3, 2010, the first outreach of the New Mexico Department of Health's harm-reduction and overdose prevention program was done in the village of Los Lunas.

In simple terms, a needle-exchange was established by the DOH. The program offers a simple exchange of clean needles for used ones, on a one-to-one ratio, said Andrew A. Gans, the department's HIV, STD and Hepatitis Section Manager.

"Our aim is to have harm reduction and overdose prevention available across New Mexico," Gans said. "Starting with the all the larger communities, we expand sites based on need and resources."

The New Mexico Harm-Reduction Act was passed in 1976 and the program opened in 1998.

In 2012, across the state, the program has distributed more than 3.1 million clean needles and collected nearly as many. In the same time period, 4.264 unduplicated clients used the exchange program and 2,100 new clients enrolled.

Gans said that while New Mexico has 7 to 8 percent of the needle use in the country, it is only about one percent of the population.

Recognizing this was a crisis matter, the state implemented the program, the first of two in the country. Hawaii also formed a statewide program in the mid 1970s.

A needle exchange program in a community, Gans said hopefully prevents the implements from being disposed of in a dangerous way, at playgrounds and parks.

"If you notice, it's been a while since (Albuquerque Police Department) has busted a shooting gallery," Gans said. "People aren't just dropping them on the ground."

If someone brings needles to the exchange, they receive a one-for-one return as well as a sharps container for the used needles.

"We probably do more than a 100 percent collection rate," Gans said.

The exchanges take any used needles, not just ones from DOH.

Gans said DOH has a needle exchange in every health region in almost every major city — places such as Albuquerque, Las Cruces, Roswell, Ruidoso, Grants and Los Lunas.

Art Salazar, the HIV health educator for the Northwest region, runs the Los Lunas exchange. He said he sees on average about seven to nine people a month.

"It takes a long time to build that trust," Salazar said. "I think a lot of people come to Albuquerque, to the larger sites, where there is more anonymity."

Salazar grew up in Valencia County and understands the perils of a small community — everybody knows you.

Gans said there are fewer than 50 registered clients at the site in Valencia County each year, and fewer than 1,000 syringes documented as being exchanged.

"This might reflect some missing data. I also think that some clients might report their residence as Bernalillo County for their privacy. I'm guessing many clients still make the trip to Albuquerque to avoid seeing people they know at a site in Los Lunas or Belen," Gans said.

Salazar said that while he encourages people using the exchange to bring in their friends and partners, that doesn't always happen.

"Individuals may come to the exchange for several friends," he said.

The focus of the exchange is to keep communities healthy by preventing the spread of diseases such as HIV and Hepatitis C.

The DOH staff at the exchanges also try to teach people using needles to be as healthy and as safe as possible, considering how they are living.

"I teach them to switch injection sites, change arms, how to treat an infected injection site," Salazar said. "I educate them on the harm to the general public if the needles aren't disposed of correctly."

And the sites are also a place for other resources such as annual flu shots and information on rehab programs.

"The whole goal of the program is to make people safer for the health and safety of our communities," Gans said. "A lot of people aren't going to walk into a public health office. We have to go to them and build that trust."

The locations of the needle exchange sometimes change in a community, Salazar said, so a visit to www.nmhivguide.org to check the current exchange location is wise.